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The waiting game

Golden handshakes 'don't work', admits NHS England primary care lead

Offering financial incentives to attract GPs to areas of poor GP recruitment ‘doesn’t work’, NHS England’s primary care commissioning lead has admitted, despite forming a major part of its recruitment strategy.

Speaking at the Westminster Health Forum in London today, NHS England’s head of primary care commissioning Dr David Geddes acknowledged that the NHS in England doesn’t yet know how to recruit GPs to areas including rural practice, adding that ‘golden handshakes’ to new GPs taking up roles in under-doctored areas just create ‘bidding wars’.

But this comes just a month after NHS England announced its ‘ten point plan’, which included plans to offer golden handshakes, while individual GP practices, Health Education England and local commissioners around the country are already offering tens of thousands of pounds to recruit new GPs to fill vacant posts.


However, Dr Geddes said today: ‘We know that golden handshakes don’t really work… We end up just getting bidding wars between different areas.’

He said the NHS needs to test other ways of attracting GPs, highlighting an example in Hull where he said GP practices are trying to make posts more attractive by ‘rotating’ new GPs, allowing them to work in GP practices, in CCGs, in public health and acute care, and are even given sabbaticals.

Dr Geddes added: ‘There are some innovative things that are happening… [bids] to draw people into these areas, which we need to test out. We don’t know yet if they’re all going to work but we need to be able to be creative and take advice from around the world.’

His comments come just weeks after NHS England published its £10m, 10-point plan to solve the GP recruitment and retention crisis, which included measures such as a time-limited incentive scheme for GP trainees committing to work in an under-doctored area for at least three years, including financial support, as well as offering financial incentives to returners opting to go work in under-doctored areas.

CCGs and Health Education England are already sponsoring ‘golden hello’ payments in Essex, while the local authority in Leicester as well as partners in individual GP practices are offering financial incentives to potential recruits.

Yesterday the RCGP claimed that some areas of England will be needing more than a 50% boost to GP numbers within five years, or 8,000 new full-time equivalent GPs in total.

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Readers' comments (34)


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  • in other words we will try anything other than actually solve the problem of too few GPs doing too much work and pointless work.

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  • Vinci Ho

    At least he is honest this time admitting NHSE has no bloody clue what to do. Yes, being the 'middle man' , you have to clean up the mess created by your boss(es).......

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  • "Dr David Geddes acknowledged that the NHS in England doesn’t yet know how to recruit GPs"

    Pretty much sums up their total ignorance of the situation

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  • Why dont they ask the donkeys carrying the burden,why wasnt this sorted with the 2004 contract.

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  • This was sorted in 2004 - partners deferred retirement, more people became GPs, people worked hard.
    Then government attacked personal allowances, pension contributions, GP practice remuneration, extended hours payments whilst encouraging the dumping of work on GPs, stoking demand and overwhelming general practice with bureaucracy.
    A contract shouldn't be the gold standard for a generation. At the time it was fine. Now it has been debased and there is a crisis.
    Time for a new negotiation.

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  • Pay them properly and they will come.

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  • Young, intelligent, highly trained professionals won't put up with this shit . It's economics ,stupid .

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  • Please remember this is the man who said "its not about saving practices, its about good patient care". Having watched general practice burn since and surley having been part responsible, he is now given the job to save it. The above mentioned attitude must first change, giving GP;s some respect and autonomy first, looking after them, paying them what they deserve and none of this waffly rubbish thats coming out. You might get some interest then, maybe even from Australia. I don't see it happening because of Pensions raid, no seniority to appreciate time in service, continued denigration from all and sundray, GMC, CQC, over regulation, ongonig fear of unwaranted and encouraged complaints....

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  • The 'golden handshake' was always to small. To relocate house you'd be looking at around £5k stamp + 1K legal + 1K removal + 1K mortgage fee + survey etc so most just gets swallowed up in the move. A proper relocation package may be more useful but ultimately doctors go to jobs they like the look of and that fulfil their career aspirations.

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